Crucial Conversations!

Friday February 7 , 2025

a woman in a black and white photo is talking to a group of women

Let me start by being vain. I’m going to assume that this newsletter has a massive and devout fanbase, and therefore necessitates an apology for leaving you breathlessly waiting for the next article these past few months.

In any event, I’m happy to be back at the typewriter. And since I will be co-presenting a keynote on Crucial Conversations with the book’s co-author Emily Gregory at Inner Circle 2025 this week, I figured it would be a good topic to start the year off with.

In our dental practices, one of our core values is Radical Candor. Which is great in theory, but makes people cry in real life.. No matter how hard we tried to implement this core value, our team largely resisted the idea of providing brutal and honest feedback to their co-workers. What was missing was the tools and the ability to hold those conversations effectively and constructively. Several years ago I was at a dental conference hosted by my friend, Steve Anderson, and I had the privilege of watching Emily speak on Crucial Conversations, and I realize that this was the bridge that we needed as an organization that would take us from walled-off silos to Radical Candor.

Spoiler alert: I’m not going to teach you how to get better at crucial conversations in the next 5 paragraphs. I’m going to teach you why you need to get better at them.

So what is a crucial conversation? Basically, it’s any conversation where the stakes are high, there are opposing viewpoints, and strong emotions. What do these look like in the dental practice? Here’s a few examples that I know you have seen in your practice:

Explaining to a patient that they need a lot of work, even though their last dentist said everything was “fine”
Having a conversation with a parent who is continually late or no-shows their child’s appointment
Addressing a team member who constantly shows up late to morning huddle (if you’re not doing morning huddles shame on you, I’ll write a newsletter on that at some point in the near future)
Dismissing a team member
Discussions about PTO, pay raises, and myriad HR policies

So yeah, pretty much a daily occurrence in the dental practice. It’s easy to see why we need to get better at having these conversations. So why don’t we?

First of all, our stupid brains have millions of years of evolution that have equipped us for fighting off a saber-toothed tiger, or running away from a stampeding mastodon. The fight or flight response is really neat until it kicks in when we are trying to hold an emotionally charged meeting with our office manager.

Secondly, most of us have had very poor models for dealing with crucial conversations. As kids, most of us watched our parents fail miserably at communicating with each other when emotions ran high (thanks for nothing mom and dad). Hollywood hasn't exactly been our ally here either. In reality, crucial conversations rarely conclude with dramatic showdowns or storybook resolutions.

Finally, we are terrible at crucial conversations for the same reason you don’t place a lot of zirconia crowns: we tend to avoid the things we aren’t good at.

If you find yourself wondering if it’s really worth all the effort, time, and money to master crucial conversations, I have a perfect example for you of why it’s so important.

We have an absolute rock star Director of First Impressions at one of our locations. Our regional manager called me in a panic saying that she had just turned in her two week notice. I asked her to reach out to the team member and see what needed to be done.

Using the skills they both had learned through our training with crucial conversations, they were able to quickly get to the heart of the issue. I’m happy to say that the employee is still happily employed with us and is a lynchpin of the team culture at her practice. That one interaction alone paid for the training we had done as a team.

So how do we get better at holding crucial conversations? Same way we get better at anything else in life. We study a model framework, practice those tools and techniques through role play, review and analyze our performance, and continue with iterative rounds of practice and feedback.

Start with buying and studying (not just reading) the book Crucial Conversations. Use the techniques in everyday life, both at home and at your practice. Make room in your schedule where you aren’t seeing patients to work with your team on the concepts presented in the book. Create a culture where crucial conversations are welcomed and seen as an opportunity for everyone in your practice to improve their communication skills. Bonus points if you take your team to a Crucial Learning seminar or engage a coach to come to your practice.

I’m not going to say that leveling up to pro in Crucial Conversations is a superpower, but it’s pretty damned close. I can admit that I’m nowhere near pro yet, and I have already reaped massive benefits from my ability to effectively communicate with my team members, colleagues, and business counterparts. Not surprisingly, the ability to communicate effectively has spilled over into my personal relationships as well and have had a profound impact in my most important relationships of all. Who knows? Maybe someday our kids will write a newsletter thanking mom and dad for modeling healthy and positive communication.